1. DEHP Nanodroplets Leached From Polyvinyl Chloride IV Bags Promote Aggregation of IVIG and Activate Complement in Human Serum
- Author
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Connor R. Monticello, Jared R. Snell, John F. Carpenter, Theodore W. Randolph, Emma L. Ross, Ashley Frazer-Abel, and Cheng Her
- Subjects
endocrine system ,Surface Properties ,Pharmaceutical Science ,02 engineering and technology ,Protein aggregation ,030226 pharmacology & pharmacy ,Gas Chromatography-Mass Spectrometry ,Article ,Protein Aggregates ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Protein stability ,Drug Stability ,Plasticizers ,Diethylhexyl Phthalate ,Humans ,Immunologic Factors ,Particle Size ,Polyvinyl Chloride ,Complement Activation ,Drug Packaging ,Chromatography ,Protein Stability ,Chemistry ,Immunogenicity ,Phthalate ,Complement C4a ,Immunoglobulins, Intravenous ,Therapeutic protein ,021001 nanoscience & nanotechnology ,Pneumatic tube ,Complement system ,Polyvinyl chloride ,Complement C3a ,Nanoparticles ,Drug Contamination ,Rheology ,0210 nano-technology - Abstract
Concerns regarding the impact of subvisible particulate impurities on the safety and efficacy of therapeutic protein products have led manufacturers to implement strategies to minimize protein aggregation and particle formation during manufacturing, storage, and shipping. However, once these products are released, manufacturers have limited control over product handling. In this work, we investigated the effect of di(2-ethylhexyl) phthalate (DEHP) nanodroplets generated in polyvinyl chloride (PVC) bags of intravenous (IV) saline on the stability and immunogenicity of IV immunoglobulin (IVIG) formulations. We showed that PVC IV bags containing saline can release DEHP droplets into the solution when agitated or transported using a pneumatic tube transportation system in a clinical setting. We next investigated the effects of emulsified DEHP nanodroplets on IVIG stability and immunogenicity. IVIG adsorbed strongly to DEHP nanodroplets, forming a monolayer. In addition, DEHP nanodroplets accelerated IVIG aggregation in agitated samples. The immunogenicity of DEHP nanodroplets and IVIG aggregates generated in these formulations were evaluated using an in vitro assay of complement activation in human serum. The results suggested DEHP nanodroplets shed from PVC IV bags could reduce protein stability and induce activation of the complement system, potentially contributing to adverse immune responses during the administration of therapeutic proteins.
- Published
- 2020
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